BEVACIZUMAB 25MG/ML INJ,4ML (16724)    VA PRODUCT (50.68)

Name Value
NAME BEVACIZUMAB 25MG/ML INJ,4ML
VA GENERIC NAME BEVACIZUMAB
DOSAGE FORM INJ,SOLN
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
Restrict to Hematology/Oncology
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 25
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/ML
NATIONAL FORMULARY NAME BEVACIZUMAB INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BEVACIZUMAB 25MG/ML 4ML INJ
VA PRODUCT IDENTIFIER B0507
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VIAL
MASTER ENTRY FOR VUID YES
VUID 4017087
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE